How Can I Restore My Face Shape After Prior Ortho Treatment?

Q: Dr. Eppley, Prior to ortho treatment, that I didn’t need it was scared into doing. My face was shorter, rounder and skin was lifted. After only 3 months of treatment, I was left with jowls, flat non lifted face and sides that cave in like a buccal fat removal casing massive folds. 

I’ve contacted a new ortho given bite is off and was sent to an oral surgeon who say that the aggressive treatment caused  trauma and bone loss and it was a skeletal thing all along and I would have been fine and not needed if I had done more consults etc.  I’m scheduled for bone grafting treatment for almost all top and bottom arch/ridge. He wanted to do oral surgery but my ortho and him agreed less better and if I can just do min to get bite might be best. So that’s the situation I’m currently in. I know I’ll need cosmetic treatment after to get to baseline they both said and that moving the teeth to get bite better may impact the face more.

 They believe my teeth were retracted back and fake widened to tip out of bone, this caused my lower jaw to move down and back not upwards like it was. They believe my teeth in previous positions and old arch curve were pushing out my soft tissue. The problem is without surgery you can get that forward movement. I want to proceed with the plan and after get my face back closer to baseline. 

I was aging well. Attached is before and I’ll send another email on now/after. I’m scared a facelift will only cause more hollowing in that area as it pulls skin a way. I  don’t want to look different or more hollow just get back to old me. If that makes sense. 

My goal is to get the tightening/more lifted and wider sides of face and Midface back. Because if I push my finger on face it bounces back to how it used to look. I’ll send pictures of that was well.

A:Thank you for your inquiry, sending your pictures and detailing your concerns and objectives. When I distill all of this down it seems to come to the potential need for cheek augmentation to address for hollowing. That certainly seems reasonable to do with certain styles of standard cheek implants. I would agree that a facelift should not be performed as that will make your concerns worse.

Dr. Barry Eppley

Plastic Surgeon